Outcomes of outpatient visits for acute respiratory illness in veterans with spinal cord injuries and disorders

Am J Phys Med Rehabil. 2006 Sep;85(9):718-26. doi: 10.1097/01.phm.0000223403.94148.67.


Objective: Respiratory complications are a leading cause of death in persons with spinal cord injuries and disorders (SCI&D). We examined same-day and 60-day hospitalizations and 60-day mortality after acute respiratory illness (ARI) outpatient visits.

Design: A longitudinal study was conducted of 8775 ARI visits in the Veterans Health Administration (VA) (October. 1997-September 2002) by persons with SCI&D. ARIs included upper respiratory infections (URI), acute bronchitis, pneumonia, and influenza (P&I).

Results: URIs accounted for almost half of all (49%) visits. A total of 14.9% of patients with ARIs were hospitalized the same day; 30.8% were hospitalized within 60 days. Predictors of hospitalization included diagnosis of either P&I or acute bronchitis, comorbid illness, level of injury, age, and VA SCI center visit. Overall 60-day mortality was 2.9% but was 7.9% for pneumonia. Mortality was related to diagnosis (P&I: odds ratio [OR] = 9.80, 95% confidence interval [CI]: 6.27-13.33; acute bronchitis: OR = 2.00, 95% CI: 1.08-2.93), age (65+: OR = 3.96, 95% CI: 2.23-5.70), and comorbid conditions (OR = 1.94, 95% CI: 1.43-2.46).

Conclusions: P&I and acute bronchitis were associated with increased VA hospitalization and mortality rates. The case fatality rate for pneumonia is higher for SCI&D than the general population. Level of injury predicted hospitalization but not death. Efforts to improve prevention and treatment of ARIs in persons with SCI&D are needed.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Ambulatory Care Facilities / statistics & numerical data
  • Comorbidity
  • Databases as Topic
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Racial Groups
  • Respiratory Tract Infections / epidemiology*
  • Retrospective Studies
  • Spinal Cord Diseases / epidemiology*
  • Spinal Cord Injuries / epidemiology*
  • United States / epidemiology
  • United States Department of Veterans Affairs